Individual
MARK THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 N GRAHAM ST STE 555, PORTLAND, OR 97227-2007
(503) 288-7535
(503) 288-7538
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD192179
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500654902
—
OR
Enumeration date
03/09/2009
Last updated
11/29/2021
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